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Fever, chills, and hypotension following cardiac catheterization with single- and multiple-use disposable catheters
Insights
Reusable cardiac catheters, when carefully cleaned, do not significantly increase patient adverse reactions like hypotension or fever. This study suggests reuse is a safe and cost-effective alternative to single-use devices.
Area of Science:
- Cardiovascular Medicine
- Infectious Disease Control
- Medical Device Sterilization
Background:
- Pyrogen reactions historically linked to multiple-use cardiac catheters prompted a shift to single-use devices, increasing costs.
- Concerns about infection and adverse events drove the practice of discarding catheters after one use.
Purpose of the Study:
- To evaluate the endemic rate of adverse reactions associated with the practice of cleaning and reusing cardiac catheters.
- To compare adverse reaction rates between single-use and multiple-use cardiac catheters.
Main Methods:
- Prospective evaluation of 341 patients undergoing cardiac catheterization.
- Comparison of adverse reaction incidence (hypotension, fever, chills) between patients receiving single-use versus multiple-use catheters.
Main Results:
- Overall adverse reaction rates: hypotension (27%), fever (3%), chills (3%).
- No statistically significant increase in adverse reactions was observed with the reuse of cardiac catheters.
- Bacterial infection was not identified as the cause of reactions; angiographic dye was a potential factor.
Conclusions:
- Careful cleaning and reuse of cardiac catheters do not appear to significantly increase infection risk.
- Catheter reuse plays a minor role, if any, in the development of other adverse reactions such as hypotension, fever, or chills.
Abstract:
Recognition of pyrogen reactions in patients studied with multiple-use cardiac catheters led to recommendations regarding their cleaning and ultimately to the expensive practice of discarding catheters after a single use. Primarily because of cost considerations, our laboratory continued to clean and reuse catheters through 1981. This afforded an opportunity to assess the endemic rate of adverse reactions associated with this practice. We prospectively evaluated 341 patients who were studied with single-use or multiple-use catheters. The overall incidence of adverse reactions was: hypotension 27%, fever 3%, chills 3%, and all three 0.6%. There were no statistically significant increases in these reactions associated with the reuse of catheters. Bacterial infection did not appear responsible for these reactions, and it is possible that they were due to angiographic dye. We conclude that careful cleaning and reuse of catheters does not create an obvious increase in the risk of infection, and it appears to play a minor role, if any, in the development of other adverse reactions.